For many athletes, both planned and emergency hospital visits for treatment and surgery may be particularly necessary because of sports injuries and sports-related surgeries. However, athletes who competed in sanctioned events must take certain steps to account for anti-doping rules, which prohibit substances and methods that may be used during treatment or surgery at a hospital.

There are different steps to take for planned and emergency hospital treatments, but athletes’ health and well-being must always remain the top priority. Consequently, emergency medical care should never be withheld on grounds that the substance or method is prohibited. Keep in mind that all the decisions about your medical care are between you and your physician.

Use the checklists below to address your anti-doping responsibilities before a planned hospital visit, or during and after an emergency visit.

Planned Hospital Visit for Treatment or Surgery

Before meeting with your physician to finalize a treatment plan, download a TUE application form and bring it to your appointment in case you need to apply for a TUE.

Talk with your physician about the recommended treatment. Make sure your doctors and nurses know that you are an athlete subject to drug testing and that you would like to check the prohibited status of all medications and methods that you may receive during treatment.

Search for the medications on GlobalDRO.com or contact Athlete Express by calling Toll-Free at 866-601-2632 or 719-785-2000 or international toll-free at +8008-120-8120 or by emailing athleteexpress@usada.org to find out if any of the medications are prohibited. USADA can also help you determine if any of the methods are prohibited.REMEMBER: All IV infusions and/or injections of any substance, prohibited or permitted, in excess of 100 mL per 12-hour period are prohibited at all times, except for those legitimately received in the course of hospital treatment, surgical procedures, or clinical diagnostic investigations. In all other circumstances, an approved TUE is required in advance of an IV infusion above the limit and/or involving a prohibited substance.

If the proposed substances or methods are prohibited, ask your physician if any non-prohibited alternatives are appropriate for your treatment. You can find non-prohibited alternatives for most medications by searching GlobalDRO.com or by reviewing the Wallet Card.

If you need to use a medication that is prohibited at all times, you must apply for a TUE.

If the medications are prohibited in-competition, think about when you will next be competing. If there is any chance that any medications will still be in your system when you compete, then you should apply for a TUE. Because excretion rates vary for each medication and from person to person, USADA cannot provide clearance estimates.

Submit the TUE to USADA in advance of your treatment involving a prohibited substance or method. Let USADA know when your surgery (or other treatment) will take place.

Emergency Hospital Treatment or Surgery

Your health is the top priority, but if you are able, inform your physicians and nurses that you are an athlete subject to drug testing and let them know that you will need to get copies of all clinical notes listing the medications that you received during your treatment.

If it provides peace of mind, you or a representative can contact USADA’s Drug Reference department to let them know that you are receiving emergency medical treatment. You and your physicians should determine the best medical care, so DO NOT CONTACT USADA TO APPROVE TREATMENT. The goal of notifying USADA is to allow us to help you get all the necessary paperwork for a TUE application if a TUE is needed. It is not required to notify USADA at this stage.

When you have time or when you are released from the hospital (whichever comes first) check all of your medications on GlobalDRO.com or call Athlete Express to determine if a TUE is required.

If you received a prohibited medication during treatment, USADA will help you apply for an Emergency TUE. When you’re being discharged from the hospital, it’s also helpful to request a complete copy of the hospital medical records to accelerate the TUE process.